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Abstract

The cost of treating pressure sores is on the rise, and recently the use of digital technology has been introduced into home care wound management strategies to increase the effectiveness of nursing visits and reduce overall costs of care. Through the digital images of a patient's wound, a primary nurse collaborates with a wound care specialist to determine best practise for wound care. The use of this technology has subsequently led to decreased home care visits, reduced costs and improving patient outcomes.
Background: The prevalence of pressure ulcers in the United
States is estimated at between 1.5 and 3 million people, and the
annual cost of treatment of such sores is approximately $8.5
billion. Approximately 31% of home care referrals are for pressure
sore care. In recent years, the use of digital photography has been
introduced into various clinical settings such as cardiology,
dermatology, pediatrics, trauma, and mental health. The focus of
digital photography use is in early interventions, acute and
chronic care, post-hospital management, and long-term care
management. This study examines the introduction of digital
photography into home care wound management, and its effects on the
efficacy of the visits by wound care nurses and on the reduction in
the cost of wound care.

Method: A pilot project was conducted in two counties in
New Jersey where digital photography was used to improve wound care
outcomes. Home care nurses were trained in the use of digital
cameras, including accurate lighting techniques, camera type, as
well as distance and settings necessary to ensure high quality
photographs. On the initial home visit, the primary nurse assesses
and documents the severity of the wound and then takes a digital
photograph of the wound. After the visit, the nurse downloads the
image onto a central computer. A wound specialist nurse assesses
the image and evaluates the wound based on size, color, and
condition of the skin surrounding the wound. In collaboration with
the primary nurse and the individual, the wound specialist nurse
develops a specific treatment plan for the patient.

Results: The use of digital photography for home care
wound management resulted in more rapid and complete wound healing
for wound care patients. Further goals for the program include
decreasing the costs of wound care by reducing the number of home
care visits and creating a more efficient use of wound
supplies.

Conclusion: Using digital technology to evaluate and
develop wound management techniques led to increased home care
wound patient healing rates and decreased outcome related costs.
Digital photography is very useful in the care of patients with
complex wounds who require a higher level and frequency of care
than what is offered through home care programs. Furthermore, this
technology will help provide higher levels of care by incorporating
wound care specialists in treatment management, without requiring
home visits by such high cost specialists. Currently in Ontario,
Saint Elizabeth Health Care has implemented the use of digital
photography in their treatment of wound care patients. There are
issues, however, with the implementation of such technology. The
quality of photographic image will depend on lighting and
environmental issues, which could alter the image. Nurses must be
properly trained in the use of digital photograpy to deal with
these issues and to ensure accurate analysis of the photograph.

Reference: Demarest L., Acoraci R. "Choosing and using a
digital camera in home care". Home Healthcare Nurse. 2004; 22(1)
61-63